Prenatal findings and pregnancy outcome in fetuses with right and double aortic arch. A 10-year experience at a tertiary center

Vol. 61 No. 4, 2020

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Ana-Maria Petrescu, Dan Ruican, Ciprian Laurentiu Patru, George Lucian Zorila, Stefania Tudorache, Alexandru Cristian Comanescu, Anca-Maria Istrate-Ofiteru, Anne Marie Badiu, Mihai Ioana, George Alin Stoica, Dominic Gabriel Iliescu

Objective: Our objective was to evaluate the accuracy of the prenatal diagnosis and the relation between the type of right aortic arch (RAA) with other intra- or extracardiac (EC) and chromosomal anomalies. Methods: A retrospective, observational study was conducted between 2011-2020 in a Romanian tertiary center. All RAA cases, including double aortic arch (DAA), were extracted from the databases and studied thoroughly. Results: We detected 18 RAA cases: five (27.78%) type I (mirror image, V type), 11 (61.12%) type II (U type), and two (11.10%) DAA cases. Heart anomalies were associated in 38.89% (overall), 60% (type I), 36.37% (type II), and 0% (DAA) cases. Tetralogy of Fallot represented the most prevalent cardiac malformation (in 22.23% of cases). EC anomalies were present in 44.44% of fetuses (20% of type I, 54.55% of type II, and 50% of DAA cases). Genetic abnormalities were found in 41.17% of pregnancies, with 22q11.2 deletion in 23.53%. 55.55% of the cases had a good neonatal evolution and 44.45% of the pregnancies were terminated. An overall good outcome of pregnancy was noted in 40% of type I RAA, 63.64% of type II RAA, and 50% of DAA cases. All RAA cases examined in the first trimester were correctly diagnosed. Conclusions: RAA can be accurately diagnosed and classified by means of prenatal ultrasound since early pregnancy. A detailed anatomy scan and genetic testing, including 22q11 deletion, should be offered to all pregnancies when RAA is discovered. When isolated, RAA associates a good outcome, indifferently the anatomical type.

Corresponding author: Ciprian Laurentiu Patru, MD, PhD; e-mail: patru_ciprian@yahoo.com; Anca-Maria Istrate-Ofiteru, MD, PhD; e-mail: ancaofiteru92@yahoo.com

DOI: 10.47162/RJME.61.4.19 Download PDF
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